CORRELATES OF POSTMENOPAUSAL FEMALE HORMONE USE AMONG BLACK-WOMEN IN THE UNITED-STATES

Objective: To assess correlates of the use of postmenopausal female ho rmone supplements among black women. Methods: We assessed information obtained from 64,564 U.S. black women 21-69 years of age who enrolled in the Black Women's Health Study in 1995 by completing postal questio nnaires. Included in the present analyses were 13,352 women 40-69 year s of age who had ceased menstruating. Most resided in ten states, with 66% from California, New York, Illinois, Michigan, Georgia, and New J ersey; 41.0% had completed college. Results: Among the 13,352 women 40 years of age or older who had ceased menstruating, 49.2% reported eve r use of female hormone supplements and 33.3% were using them currentl y. Unopposed oral estrogens accounted for 63.4% of the medications bei ng used currently. The use of supplements was highest in the western U .S. and lowest in the Northeast. The strongest correlate of use was me nopause due to bilateral oophorectomy. Use peaked at 50-54 years of ag e and then declined, and also was associated positively with lower bod y mass index, greater years of education, participation in vigorous ex ercise, and past oral contraceptive use. Use was associated inversely with having a positive history of diabetes, heart attack, or breast ca ncer. Some of the drug use reported was at variance with. suggested gu idelines: unopposed estrogen was taken by some women who had a uterus, and estrogen together with a progestin was taken by some women who ha d had a hysterectomy. Conclusion: These data indicate that patterns of use of postmenopausal female hormone supplements among black women wh o participated in the present study are similar to those documented in white women. Women with risk factors for coronary artery disease were not more likely to use supplements than women at lower risk, a patter n that is not in accordance with suggestions that the greatest benefit of supplements may accrue to high-risk women. Because users differ fr om nonusers in important characteristics that may affect the incidence of coronary heart disease, breast cancer, and other illnesses, observ ational studies of the health effects of these medications must contro l carefully for correlates of use. (C) 1998 by The American College of Obstetricians and Gynecologists.